Oral Contraceptives and Your Skin

by Angela IrishAugust 14, 2018

We know that the appearance of our skin is often a direct reflection of something going on somewhere inside the body. Whether it’s an underlying health condition or occasional stress, the skin really is a mirror to your health. But sometimes, when our skin changes, it’s a result of something that we are doing or adding into the mix – for example, medications. It’s not at all uncommon to experience skin-health related side effects from medications. These effects can range from mild dryness and photosensitivity to a full on acne flare up.

One type of medication that we’ve come to associate with skin changes is the class of oral contraceptives, more affectionately known as “the pill.” In fact, some doctors even prescribe oral contraceptives as a remedy to common skin issues such as acne. While many women do experience the benefit of clear, beautiful skin while taking the pill, there is actually an entire range of effects that it can have on your skin health – some good and some not so great.

It’s estimated that more than 60% of women who are of reproductive age have used or are using oral contraceptives. Considering that the pill is one of the most common medications that women take, we thought it would be a good idea to talk about how it can change your skin, in ways both good and bad.

Hormones Everywhere

Personal experience with the pill varies. Some women benefit from less acne and a fresh glow, while others experience a slew of skin issues they never encountered before. Regardless of the outcome, there is one thing responsible for the changes and that’s – you guessed it – hormones.

While acne can affect both men and women, women are often prone to it throughout various times in their life outside of the usual teen years. This is due in a large part to the fact that women experience a wider range of hormone fluctuations throughout their life. Practically every teenager knows that a rush of hormones can trigger a breakout, but hormonal changes down the road can be equally disruptive – PMS and pregnancy for example. For many women, perimenopause also brings about a new batch of skin issues, including acne that seemingly should have been left in the past decades ago.

Oral contraceptives consist of various types and concentrations of hormones, so it only makes sense that they should have an affect on the skin. In many cases, the pill will level out and balance hormone levels, which is why many doctors prescribe it instead of other medications that can control acne but come with more serious side effects.

Androgens, a typically “male” hormone, is the main cause of hormonal acne. The presence of androgens triggers an excess production of sebum, which is the skin oil responsible for the not-so-lovely sheen of an oily face. As sebum settles into the pores, it can clog them and eventually lead to acne. During puberty, both males and females experience an up-tick in androgen production.

While men produce more androgens, a woman’s adrenal glands and ovaries do produce a small amount, which happens to increase right before her period. But for women who take oral contraceptives, the estrogen and progestin in the pill balances these fluctuations, resulting in a reduction of hormone-related flare ups. But, like all things, there are positives and negatives. The pill can be great for your skin, or it cause a few new problems. Let’s take a quick look at both sides of the coin.

Oral Contraceptives for Skin Health

While no medication is without side effects, at this point we have become relatively comfortable with the side effects associated with oral contraceptives and many women feel that the benefits outweigh any risks. This is why many doctors will prescribe the pill for women with acne issues, whether they need the contraceptive benefit from the medication or not. This isn’t to say that the pill should be the first line of treatment when hormonal changes spur acne and other skin issues. Treatment, and the decision whether or not to use the pill for skin health, should be something that a woman discusses and agrees upon with her health care provider.

When considering the pill, many women have questions about what type of benefits they can expect to see in the appearance of their skin. This will of course depend on the woman herself, but within a few months many women see some very significant improvements in the health and texture of their skin.

We already mentioned the hormone connection, and how an increase of androgens leads to breakouts. As the pill halts that production, it quiets inflamed acne and the triggers that cause it. While the pill doesn’t offer an overnight, magical solution for severe acne, over the course of a few months, most women find that the appearance of their acne has reduced and that new breakouts are much less common.

Those pesky androgens can cause issues other than acne. You know those few chin hairs that you pluck out, or that upper lip fuzz that seems to be a little more noticeable than it was a couple year ago? Yep, that’s good old androgen at play. While most women have a little bit of facial hair that is either not noticeable or can be easily taken care of, some women have facial hair that is thicker, coarser and more noticeable. The pill can reduce androgen levels to the point that excess hair production stops, or at least slows down to the point that an occasional wax easily takes care of it.

Is There a Downside?

Unfortunately, the pill isn’t a magical cure for all your skin woes. In fact, it can even cause some new skin issues to occur. If you require a certain type of oral contraceptive, or just happen to be pleased with the one you’re taking, rest assured that most of the time any skin-related side effects of the pill are mild and can be controlled with a few preventative measures.

Take for example, one of the most common skin related complaints of women taking the pill – minor skin discoloration. Some women notice minor patches of light skin discoloration along their upper lip, forehead or cheek area. These discolorations are often hormone related but made worse by exposure to the sun or even just being out in the heat. If these discolorations become more noticeable or you are bothered by them, it’s always good to talk with your doctor about other prescription options that are available.

However, often times it isn’t necessary to switch up your prescriptions. Simple steps like regular exfoliation or a gentle peel are enough to slough away surface skin cells and minimize the appearance of any discolorations. There are also skin lightening products that can be used to treat minor cases of hyperpigmentation, just be sure to focus on quality when choosing one.

Why All Hormonal Contraceptives Aren’t Created Equal

So, if you used one type of oral contraceptive in the past and had great skin as a result, it’s safe to assume that any pill you use will have the same effect, right? Unfortunately, the answer to this question is no, not at all.

Every type of birth control pill uses as synthetic form of progesterone known as progestin. But, there are many different types of progestin, some that are low in androgenic activity and others that seem to ignite it. This is why some women can have such great results with the pill, while others feel like they’ve entered the beginning stages of puberty all over again.

For example, Drospirenone is an anti-androgenic progestin that is used is some popular oral contraceptive pills. Norgestimate, is a low androgenic progestin that is used in some pills, like Ortho Tri Cylcen, which has been successfully used by women for years.

Then, there are other progestins which generally don’t yield as many skin-related benefits. There are some oral contraceptives that contain progestins such as Norethindrone, which is great for the pill’s main intended use, but really doesn’t do much for the health of your skin. This type of progastrin is a medium androgenic, meaning that it probably won’t cause new issues for your skin, but chances are that it won’t exactly help to make it better either.

This brings us to the issue of other forms of hormonal contraceptives. Women have other options that include implants, IUDs, insertable rings and injections to provide contraceptive protection. Many women tend to think that since the pill has a reputation of clearing acne prone skin, that other forms of hormonal contraceptives will have the same effect. Unfortunately, this is not usually the case. In fact, the opposite is often true.

These types of hormonal contraceptives often include highly androgenic progestins such as Levonorgestrel, Nogestrel, Etonogestrel, and DMPA which are known triggers for acne. This isn’t to say that every woman that uses these medications will have skin-related side effects, but it isn’t uncommon for them to appear. It’s a good idea to speak with your doctor about these specific progestins if you’re concerned about developing or worsening acne.

One more factor in a pill’s ability to work to create beautiful skin is the presence of estrogen. Most types of oral contraceptive include at least some amount of estradiol, the synthetic form of estrogen. Oral contraceptives that contain at least moderate amounts of estradiol, are generally more likely to reduce acne and present fewer skin related side effects. Some pills, often referred to as the “mini-pill”, are progestin only or extremely low in estradiol and will often not have the same skin health benefits as the combined variety.

While there may be general standards that apply to each type of oral contraceptive, each woman may react differently. What works for one might not work for the other. When taking oral contraceptives for skin care, or any other medication for that matter, it’s important to meet with your physician regularly to evaluate your prescription needs and determine if your current prescription is the best choice for you moving forward.

There unfortunately isn’t a magic bullet for healthy, beautiful skin. Even with helpful medication that can improve the health of your skin, it’s important to invest in a self-care routine that makes daily skin care a priority.